Development and Evaluation of the Effectiveness of a Communication Innovation for Intubated Patients

Abstract

Communication is a fundamental component of nursing care, particularly for patients with endotracheal intubation who are unable to communicate verbally. This study aimed to develop and evaluate the effectiveness of a communication innovation for patients with endotracheal intubation using a research and development approach. The study was conducted in three phases: Phase 1 involved an assessment of problems and needs; Phase 2 focused on the design and development of a communication innovation entitled “A Box Representing Your Heart”; and Phase 3 evaluated the effectiveness of the innovation using a quasi-experimental two-group pretest–posttest design.

Participants were 60 patients with endotracheal intubation, who were randomly assigned and matched by age and educational level into an experimental group (n = 30) and a control group (n = 30). The research instruments included: (1) a semi-structured interview guide for focus group discussions, which demonstrated a content validity index (IOC) of 0.98; (2) the experimental intervention, namely the communication innovation “A Box Representing Your Heart,” which was evaluated and found to have overall appropriateness at the highest level; and (3) an instrument for assessing the effectiveness of the communication innovation for patients with endotracheal intubation. The effectiveness assessment demonstrated excellent content validity, with item–objective congruence (IOC) values of 1.00 for all items, and satisfactory reliability, with a Cronbach’s alpha coefficient of 0.79. Data analysis was conducted in two parts. Qualitative data obtained from focus group discussions with patients, family members, and nurses were analyzed using content analysis to identify communication-related problems, barriers, and needs, which informed the contextualized development of the innovation. Quantitative data were first tested for normality using the Shapiro–Wilk test (p > .05), followed by descriptive statistics to summarize participant characteristics. Chi-square tests and independent t-tests were used to examine baseline equivalence between groups. Paired t-tests were conducted for within-group comparisons, and independent t-tests were used for between-group comparisons to evaluate the effectiveness of the innovation. The results of the development of the communication innovation “A Box Representing Your Heart” indicated that the overall quality of the innovation was rated at the highest level (M = 4.74, SD = 0.48). The effectiveness evaluation showed that the experimental group using the innovation demonstrated a statistically significant increase in mean communication effectiveness scores after the intervention (pre-intervention: M = 45.20, SD = 5.10; post-intervention: M = 53.60, SD = 4.85; t = −8.75, p < .001), whereas no statistically significant difference was observed in the control group (p > .05). Between-group comparisons revealed that the experimental group had significantly higher communication effectiveness scores than the control group (t = 6.35, p < .001).

The developed communication innovation demonstrated good effectiveness in enhancing communication among patients with endotracheal intubation. It can be applied in clinical settings to improve the quality of care, reduce patient anxiety, and strengthen relationships among patients, family members, and healthcare professionals.